191202138-3-1-2025-31-AS-NMAN-DK8R6Q-20250804124503

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 191202138
Report Date: 02/28/2025
Date Signed: 03/01/2025 01:40:53 PM

Unsubstantiated

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
WOODLAND HILLS S.RO, 21731 VENTURA BLVD., STE. 250
WOODLAND HILLS, CA 91364

This is an official report of an unannounced visit/investigation of a complaint received in our office on
07/10/2024 and conducted by Evaluator Leizl De La Cerra

COMPLAINT CONTROL NUMBER: 31-AS-20240710140951

FACILITY NAME:	TIERRA DEL SOL		FACILITY NUMBER:	191202138
ADMINISTRATOR:	NANCY BISSONETTE-ANDREW		FACILITY TYPE:	775
ADDRESS:	9919 SUNLAND BOULEVARD		TELEPHONE:	(818) 352-1419
CITY:	SUNLAND	STATE: CA	ZIP CODE:	91040
CAPACITY:	304	CENSUS: 65	DATE:	02/28/2025
		UNANNOUNCED	TIME BEGAN:	10:15 AM
MET WITH:	Sandy Lara, Program Director		TIME COMPLETED:	03:30 PM

ALLEGATION(S):

1
2
3
4
5
6
7
8
9

Client sustained multiple unexplained injuries while in care.

INVESTIGATION FINDINGS:

1
2
3
4
5
6
7
8
9
10
11
12
13

Licensing Program Analyst (LPA) Leizl de la Cerra conducted an unannounced subsequent complaint visit to this facility to investigate the above allegation and deliver findings. At 10:30AM, LPA met with the front desk staff, and LPA explained the reason for the visit. LPA was met by Sandy shortly thereafter.

Regarding the allegation: Client sustained multiple unexplained injuries while in care.
It has been alleged that non-verbal C1 who attends the day program at Tierra del Sol came home with bruises on two separate occasions, 7/01/24 and 7/08/24.
To investigate the allegation, LPA conducted an initial visit on 7/16/24. LPA requested copies of facility documents relevant to the investigation records included but not limited to client’s records, client and staff roster, facility program plan, internal incident log etc. LPA conducted staff interviews with staff 1(S1) and staff 2 (S2). Also, on 7/16/24 LPA also conducted the complaint visit at a 2nd location for Tierra del Sol. At the 2nd location, LPA conducted interviews with staff 3 (S3), staff 4 (S4) witness 1 (W1), witness 2 (W2) and witness 3 (W3). Additionally, LPA conducted interviews with North Los Angeles Regional Center (NLARC) staff Consumer Services Coordinator (CSC) and witness 4, (W4).
-Continue to LIC 9099C

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Naira Margaryan
LICENSING EVALUATOR NAME: Leizl De La Cerra
LICENSING EVALUATOR SIGNATURE:	DATE: 02/28/2025

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/28/2025

This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC9099 (FAS) - (06/04)

Page: 1 of 2

Control Number 31-AS-20240710140951

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
WOODLAND HILLS S.RO, 21731 VENTURA BLVD., STE. 250
WOODLAND HILLS, CA 91364

FACILITY NAME: TIERRA DEL SOL	FACILITY NUMBER: 191202138
	VISIT DATE: 02/28/2025

NARRATIVE

1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32

LPA Interviews with S1 and S2 confirms that North Los Angeles Regional Center (NLARC) provides services for C1. At the time of the incident, C1's services is comprised with attending the day program at Tierra del Sol, specifically a workforce development program, which is an in-person volunteer job, five times a week.
C1’s customized routine when attending the program, starts out with being dropped off at Tierra Del Sol day program by R&D Transportation which is an approved vendor for (NLARC) North Los Angeles Regional Center. R &D transportation is not affiliated with Tierra del sol.
R&D transportation is responsible for transporting C1 from C1’s residence to Tierra Del Sol in the morning and transports C1 from Tierra del Sol back to C1’s residence in the afternoon.
LPA’s review of records reveals that on 6/04/24 another client C2 admitted to a program manager, S4 that C2 physically assaulted C1 while both C1 and C2 were onboard the R&D bus, headed to their day program, Tierra del Sol. Interview with S4 revealed that the bus driver or any other clients on board the bus that morning of 6/04/24 did not witness C2 hitting C1. Records also shows that corrective actions were implemented on 6/04/24 and 6/21/24 for C2 by staff member S4, to prevent C2 from harming other clients in the bus. These corrective actions were addressed by S4 with R&D transportation however records show that R&D Transportation did not comply with one corrective action recommended and as far as the other corrective action recommended, R&D Transportation informed S4 that R&D Transportation couldn't guarantee to provide S4's request. Interview with S3 confirmed that C1 belongs to a development program that consist of only three (3) clients including C1 and there are no incidents or records of the other two (2) clients injuring C1. Interviews with R&D transportation personnel, W1,W2 and W3 confirmed that no one witnessed C1 getting physically assaulted or no on can confirm how C1 sustained injuries while on board the R&D Transportation bus during those specific dates of 7/1/24 and 7/8/24. LPA observed R&D transportation buses are not equipped with any video surveillance camera that could have provided footage for the investigation.
Based on record reviews, observations, interviews with witnesses and staff members, no one can confirm how C1 sustained injuries on 7/01/24 and 7/08/24.
Therefore, the allegation of C1 sustaining multiple unexplained injuries while in care with Tierra del Sol is deemed UNSUBSTANTIATED at this time.

SUPERVISORS NAME: Naira Margaryan
LICENSING EVALUATOR NAME: Leizl De La Cerra
LICENSING EVALUATOR SIGNATURE:	DATE: 02/28/2025

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/28/2025

LIC9099 (FAS) - (06/04)

Page: 2 of 2